To what extent is clinical and laboratory information used to perform medication reviews in the nursing home setting? the CLEAR study
| Autor: | Carlota Mestres Gonzalvo, Brigit P. C. van Oijen, Hugo A. J. M. de Wit, Paul-Hugo M. van der Kuy, Bjorn Winkens, Jos M. G. A. Schols, Wubbo J. Mulder, Frans R.J. Verhey, Rob Janknegt, Kim P G M Hurkens |
|---|---|
| Přispěvatelé: | Interne Geneeskunde, Urologie, Family Medicine, Health Services Research, Psychiatrie & Neuropsychologie, FHML Methodologie & Statistiek, RS: CAPHRI School for Public Health and Primary Care, RS: CAPHRI - R1 - Ageing and Long-Term Care, RS: CAPHRI - R6 - Promoting Health & Personalised Care, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: Academische Werkplaats Ouderenzorg, Geriatrics |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
Therapeutics and Clinical Risk Management Pharmacist Bioinformatics law.invention medication therapy management Patient safety Randomized controlled trial decision support systems management law Health care Medication therapy management medicine MANAGEMENT Pharmacology (medical) Medical history General Pharmacology Toxicology and Pharmaceutics polypharmacy medication review Original Research OUTCOMES Chemical Health and Safety business.industry Gold standard General Medicine RANDOMIZED CONTROLLED-TRIAL CARE ADVERSE DRUG EVENTS aged Family medicine business Safety Research Medication list DECISION-SUPPORT-SYSTEMS PHARMACIST |
| Zdroj: | Therapeutics and Clinical Risk Management Therapeutics and Clinical Risk Management, 11, 767-777. Dove Medical Press Ltd Therapeutics and clinical risk management, 11, 767-777. Dove Medical Press Ltd. |
| ISSN: | 1176-6336 1178-203X |
| DOI: | 10.2147/tcrm.s77428 |
| Popis: | Carlota Mestres Gonzalvo,1 Kim PGM Hurkens,2 Hugo AJM de Wit,3 Brigit PC van Oijen,1 Rob Janknegt,1 Jos MGA Schols,4 Wubbo J Mulder,5 Frans R Verhey,6 Bjorn Winkens,7 Paul-Hugo M van der Kuy1 1Department of Clinical Pharmacology and Toxicology, Orbis Medical Centre, Sittard, 2Department of Internal Medicine, Section of Geriatric Medicine, Academic Medical Centre, Amsterdam, 3Department of Clinical Pharmacy and Toxicology, Atrium Medical Centre, Heerlen, 4Department of Family Medicine and Department of Health Services Research, School for Public Health and Primary Care, Maastricht University, 5Department of Internal Medicine, Maastricht University Medical Centre, 6Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg/School for Mental Health and Neurosciences, 7Department of Methodology and Statistics, School for Public Health and Primary Care, Maastricht University, Maastricht, theNetherlands Background: The aim of this study was to evaluate to what extent laboratory data, actual medication, medical history, and/or drug indication influence the quality of medication reviews for nursing home patients. Methods: Forty-six health care professionals from different fields were requested to perform medication reviews for three different cases. Per case, the amount of information provided varied in three subsequent stages: stage 1, medication list only; stage 2, adding laboratory data and reason for hospital admission; and stage 3, adding medical history/drug indication. Following a slightly modified Delphi method, a multidisciplinary team performed the medication review for each case and stage. The results of these medication reviews were used as reference reviews (gold standard). The remarks from the participants were scored, according to their potential clinical impact, from relevant to harmful on a scale of 3 to -1. A total score per case and stage was calculated and expressed as a percentage of the total score from the expert panel for the same case and stage. Results: The overall mean percentage over all cases, stages, and groups was 37.0% when compared with the reference reviews. For one of the cases, the average score decreased significantly from 40.0% in stage 1, to 30.9% in stage 2, and 27.9% in stage 3; no significant differences between stages was found for the other cases. Conclusion: The low performance, against the gold standard, of medication reviews found in the present study highlights that information is incorrectly used or wrongly interpreted, irrespective of the available information. Performing medication reviews without using the available information in an optimal way can have potential implications for patient safety. Keywords: polypharmacy, medication therapy management, decision support systems management, aged, medication review |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|